'On the Move' Exercise Program for Improving Mobility in Older Adults

Overseen By Jennifer S Brach, PhD, PT

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Pittsburgh

Disqualifiers: Impaired cognition, Acute illness, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 24

Duration: 12 weeks

502 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to test the effectiveness of On the Move (OTM) in terms of improving mobility among 502 older adults in 44 senior community centers and to evaluate intervention fidelity, including adherence and competence, and the impact of organizational, instructor, and participant level factors on intervention fidelity.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the 'On the Move' exercise program treatment for improving mobility in older adults?

Research shows that the 'On the Move' exercise program improves mobility in older adults more effectively than standard exercise programs. Additionally, similar group exercise programs have been found to enhance balance, strength, and overall physical function in older adults. ^{1 2 3 4 5}

Is the 'On the Move' exercise program safe for older adults?

The 'On the Move' exercise program has been studied in older adults and is generally considered safe, as it focuses on improving mobility through group exercises. While specific safety data is not detailed, the program is designed for community-dwelling older adults and has been implemented without reported safety concerns. ^{1 2 3 6 7}

How is the 'On the Move' exercise program different from other treatments for improving mobility in older adults?

The 'On the Move' exercise program is unique because it focuses on the timing and coordination of walking, which has shown greater improvements in mobility compared to standard exercise programs. It can be effectively delivered by both research and lay leaders, making it accessible and potentially impactful in community settings. ^{1 2 3 8 9}

Research Team

Jennifer S Brach, PhD, PT

Principal Investigator

University of Pittsburgh

Eligibility Criteria

This trial is for older adults, aged 60 and above, who can walk on their own within the house and are regulars at senior community centers. They should be able to join group exercises but cannot have unstable illnesses or plans to move away soon. Those with impaired cognition that affects understanding of consent are not eligible.

Inclusion Criteria

Attend the senior center

I am 60 years old or older.

Can participate in group exercise classes

Exclusion Criteria

I understand the consent process.

I do not have any sudden or severe health conditions.

Plans to leave the area for an extended period of time

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the On the Move group exercise program to improve walking, delivered twice per week for 12 weeks

12 weeks

24 sessions (in-person)

Follow-up

Participants are monitored for improvements in walking ability and post-intervention persistence of benefits

12 weeks

Delayed Intervention

Participants in the delayed intervention arm receive the On the Move program after a 12-week wait-list period

12 weeks

Treatment Details

Interventions

• On the Move group exercise

Trial Overview The 'On the Move' (OTM) group exercise program is being tested for its ability to improve mobility in older adults. The study involves 502 participants across 44 senior centers and will also assess how well the program is delivered and factors affecting it.

Participant Groups

Group I: On the Move - Delayed Experimental Treatment 1 Intervention

Individuals in this arm will be placed on a wait-list for 12 weeks and will receive no intervention during this time. At the end of the 12 weeks they will receive the On the Move group exercise program. This is a wait-list control group.

Group II: On the Move Experimental Treatment 1 Intervention

On the Move group exercise program to improve walking. Delivered twice per week for 12 weeks.

On the Move group exercise is already approved in United States for the following indications:

Approved in United States as On the Move for:

• Improving mobility in older adults

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials

1,820

Recruited

16,360,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Findings from Research

Participation in the 'On the Move' (OTM) exercise program may lead to a reduced risk of hospitalization among older adults compared to a seated exercise program, although the results were not statistically significant.

While initial data suggested higher rates of falls and emergency department visits for OTM participants, these rates decreased when accounting for attendance, indicating that adherence to the program may help mitigate these risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Potential long-term impact of "On The Move" group-exercise program on falls and healthcare utilization in older adults: an exploratory analysis of a randomized controlled trial. Coyle, PC., Perera, S., Albert, SM., et al.[2021]

Live video exercise groups for older adults showed improvements in physical function, with no significant differences compared to in-person sessions, based on a systematic review of nine studies involving participants aged 65 and older.

Participants in a case study reported similar attendance rates and benefits, such as improved balance, from both virtual and in-person sessions, suggesting that live video formats can be an effective alternative for exercise programs during the COVID-19 pandemic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical Function Effects of Live Video Group Exercise Interventions for Older Adults: A Systematic Review and Veteran's Gerofit Group Case Study. Fernandez, D., Wilkins, SS., Melrose, RJ., et al.[2023]

The On the Move (OTM) exercise program did not show significant advantages over a standard exercise program when delivered by lay leaders to community-dwelling older adults, indicating that the effectiveness of such programs may depend on the qualifications of the instructors.

While there were minor differences in outcomes when OTM was taught by research leaders compared to lay leaders, these differences were statistically significant but not clinically meaningful, suggesting that professional training may enhance program effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motor Control-based Group Exercise: Can It be Delivered as Effectively by Lay Leaders? Wert, DM., Perera, S., Nutini, JF., et al.[2023]

In a study involving 167 older adults aged 65 to 96, group-based resistance training significantly improved lower-body flexibility, strength, and agility compared to home-based resistance training and walking programs.

Both home-based and group-based resistance training showed benefits in strength and flexibility, while the walking program did not lead to any improvements, highlighting the effectiveness of resistance training for functional performance in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of the effects of a home-based and group-based resistance training program on functional ability in older adults. Cyarto, EV., Brown, WJ., Marshall, AL., et al.[2008]

The Otago exercise program effectively reduces falls and improves balance, strength, mobility, and health-related quality of life for older adults, whether they are living in the community or in institutions.

Group-based Otago exercise programs may yield better outcomes compared to individual sessions, highlighting the potential benefits of social interaction during exercise for older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Otago Exercise Program on Physical and Psychosocial Functions Among Community-Dwelling and Institutionalized Older Adults: A Scoping Review. Mgbeojedo, UG., Akosile, CO., Okoye, EC., et al.[2023]

A clinical trial was designed to evaluate a new group exercise program called 'On the Move,' which focuses on timing and coordination of movement, involving significant input from stakeholders to ensure the program meets the needs of older adults.

The trial, conducted over 12 weeks with classes twice a week, aims to improve function, disability, and mobility in older adults, highlighting the importance of community involvement in creating effective exercise interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stakeholder involvement in the design of a patient-centered comparative effectiveness trial of the "On the Move" group exercise program in community-dwelling older adults. Brach, JS., Perera, S., Gilmore, S., et al.[2022]

The Gerofit facility-based exercise program successfully transitioned to a telehealth format during COVID-19, allowing 27% of participating Veterans to continue exercising remotely.

Remote physical performance testing indicated that participants were able to retain their physical function, suggesting that telehealth exercise programs can effectively mitigate health risks associated with decreased mobility in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19. Jennings, SC., Manning, KM., Bettger, JP., et al.[2021]

Group-based physical activity interventions, particularly those combining aerobic and resistance training, significantly improve mobility-related outcomes such as physical function, balance, and muscle strength in older adults aged 55 and above, based on a review of 62 systematic reviews.

There is no evidence supporting the effectiveness of nutritional supplementation alone in enhancing mobility outcomes, indicating a gap in research focused solely on nutrition for older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-based group physical activity and/or nutrition interventions to promote mobility in older adults: an umbrella review. Neil-Sztramko, SE., Teggart, K., Moore, C., et al.[2022]

Group-based physical activity interventions, particularly those combining aerobic and resistance training, significantly improve mobility, physical function, and balance in community-dwelling older adults, based on an umbrella review of 54 systematic reviews.

There is no evidence supporting the effectiveness of nutritional supplementation alone in enhancing mobility when combined with physical activity, indicating a need for further research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-based physical activity and/or nutrition interventions to promote mobility in older adults: An umbrella review. Neil-Sztramko, S., Coletta, G., Teggart, K., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Potential long-term impact of "On The Move" group-exercise program on falls and healthcare utilization in older adults: an exploratory analysis of a randomized controlled trial. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Physical Function Effects of Live Video Group Exercise Interventions for Older Adults: A Systematic Review and Veteran's Gerofit Group Case Study. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Motor Control-based Group Exercise: Can It be Delivered as Effectively by Lay Leaders? [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Comparison of the effects of a home-based and group-based resistance training program on functional ability in older adults. [2008]

5. United States pubmed.ncbi.nlm.nih.gov

Effects of Otago Exercise Program on Physical and Psychosocial Functions Among Community-Dwelling and Institutionalized Older Adults: A Scoping Review. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Stakeholder involvement in the design of a patient-centered comparative effectiveness trial of the "On the Move" group exercise program in community-dwelling older adults. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19. [2021]

8. England pubmed.ncbi.nlm.nih.gov

Community-based group physical activity and/or nutrition interventions to promote mobility in older adults: an umbrella review. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Community-based physical activity and/or nutrition interventions to promote mobility in older adults: An umbrella review. [2023]